276 research outputs found

    The IT-CMF: A Practical Application of Design Science

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    The IT-Capability Maturity Model [IT-CMF] is a high-level process capability maturity framework for managing the IT function within an organization. The purpose of this paper is to explore and explain the IT-CMF as a “ method meta-model” for IT management, emphasizing the novel approach to addressing the application of design processes and design artifacts by means of a very structured use of engaged scholarship and open innovation techniques to the ongoing challenge of managing organization’s IT capability

    Creating the future together: Toward a framework for research synthesis in entrepreneurship

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    To develop a body of evidence-based knowledge on entrepreneurship, findings and contributions from the positivist, narrative and design research traditions in this area need to be combined. Therefore, a framework for research synthesis in terms of social mechanisms, contextual conditions and outcome patterns is developed in this paper. Subsequently, a synthesis of the existing body of research findings on entrepreneurial opportunities serves to illustrate how this framework can be applied and provides results that inform entrepreneurial action. Finally, we discuss how this synthetic approach serves to systematically connect the fragmented landscape of entrepreneurship research, and thus gradually build a cumulative and evidence-based body of knowledge on entrepreneurship

    Liver Steatosis is Prevalent in Lean People With HIV and Associated With Exposure to Antiretroviral Treatment - A Cross-sectional Study

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    Background: Steatotic liver disease is suggested to have a higher prevalence and severity in people with HIV (PHIV), including in those with a normal body mass index (BMI). In this study, we used data from the 2000HIV cohort to (1) assess the prevalence of liver steatosis and fibrosis in lean versus overweight/obese PHIV and (2) assess associations in these subgroups between steatosis and fibrosis with traditional risk factors and HIV-specific characteristics. Methods: The 2000HIV study cohort comprises 1895 virally suppressed PHIV that were included between 2019 and 2021 in 4 HIV treatment centers in the Netherlands. The majority (58.5%) underwent vibration-controlled transient elastography for the assessment of liver steatosis and fibrosis. The prevalence of steatosis (controlled attenuation parameter ≥263 dB/m) and fibrosis (liver stiffness measurement ≥7.0 kPa) was estimated. Multiple factors including HIV characteristics and antiretroviral drugs were tested in a logistic regression model for association with steatosis and fibrosis. Analyses were performed separately for lean (Asian descent: BMI &lt; 23 kg/m2, other descent: BMI &lt; 25 kg/m2) and overweight/obese (other BMI) participants. Results: Of 1050 PHIV including 505 lean and 545 overweight/obese PHIV, liver steatosis was observed in 37.7% of the overall study population, 19.7% of lean, and 54% of overweight/obese PHIV, whereas fibrosis was observed in 9.0% of the overall study population, 5.9% of lean, and 12.0% of overweight/obese PHIV. All associations with fibrosis and most associations with steatosis concerned metabolic factors such as type 2 diabetes mellitus (overall population: adjusted odds ratio [aOR] for steatosis: 2.3 [1.21-4.4], P =. 011; aOR for fibrosis: 3.7 [1.82-7.53], P &lt;. 001). Furthermore, in lean PLHIV, liver steatosis was associated with CD4 and CD8 counts at enrollment, dual therapy, and history of treatment with raltegravir (aOR: 3.6 [1.53-8.47], P =. 003), stavudine (aOR: 3.73 [1.69-8.2], P =. 001), and indinavir (aOR: 3.86 [1.59-9.37], P =. 003). These associations were not observed in overweight/obese PHIV. Conclusions: Liver steatosis was highly prevalent, affecting approximately one-fifth of lean PHIV and half of overweight/obese PHIV. Fibrosis was observed in a minority. Both steatosis and fibrosis were associated with traditional metabolic risk factors. In addition, (prior) exposure to specific antiretroviral drugs was associated liver steatosis in lean, but not in overweight/obese PHIV. Implementing increased screening protocols could enhance the identification of steatotic liver disease in lean PHIV.</p

    Clinical implementation and feasibility of long-course fractionated MR-guided chemoradiotherapy for patients with esophageal cancer: An R-IDEAL stage 1b/2a evaluation of technical innovation

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    Purpose: This R-Ideal stage 1b/2a study describes the workflow and feasibility of long-course fractionated online adaptive MR-guided chemoradiotherapy with reduced CTV-to-PTV margins on the 1.5T MR-Linac for patients with esophageal cancer. Methods: Patients with esophageal cancer scheduled to undergo chemoradiation were treated on a 1.5T MR-Linac. Daily MR-images were acquired for online contour adaptation and replanning. Contours were manually adapted to match the daily anatomy and an isotropic CTV-to-PTV margin of 6 mm was applied. Time was recorded for all individual steps in the workflow. Feasibility and patient tolerability were defined as on-table time of ≤60 min and completion of >95% of the fractions on the MR-Linac, respectively. Positioning verification and post-treatment MRIs were retrospectively analyzed and dosimetric parameters were compared to standard non-adaptive conventional treatment plans. Results: Nine patients with esophageal cancer were treated with chemoradiation; eight patients received 41.4 Gy in 23 fractions and one received 50.4 Gy in 28 fractions. Four patients received all planned fractions on the MR-Linac, whereas for two patients >5% of fractions were rescheduled to a conventional linac for reasons of discomfort. A total of 183 (86%) of 212 scheduled fractions were successfully delivered on the MR-Linac. Three fractions ended prematurely due to technical issues and 26 fractions were rescheduled on a conventional linac due to MR-Linac downtime (n = 10), logistical reasons (n = 3) or discomfort (n = 13). The median time per fraction was 53 min (IQR = 3 min). Daily adapted MR-Linac plans had similar target coverage, whereas dose to the organs-at-risk was significantly reduced compared to conventional treatment (26% and 12% reduction in mean lung and heart dose, respectively). Conclusion: Daily online adaptive fractionated chemoradiotherapy with reduced PTV margins is moderately feasible for esophageal cancer and results in better sparing of heart and lungs. Future studies should focus on further optimization and acceleration of the current workflow

    Towards an integrative view of innovation in food sector SMEs

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    Most literature on innovation focuses on organizational engagement with innovation types in isolation from one another. By establishing the interdependency of innovation types in SMEs in the UK food sector, this study provides evidence to support the case for a more holistic approach in innovation research. Thus the study both contributes to the limited research on innovation in food sector SMEs and supports the integrative view of innovation. Using questionnaire-based data, structured equation modelling was used to propose and test the interrelationships between the level of engagement with product, process, position and paradigm innovation. A significant positive relationship between innovation types was identified

    Being careful what we wish for? Challenges and opportunities afforded through engagement with business and management research

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    Despite the proliferation of work within construction management that draws upon management and organizational theory, two omissions stand out from the body of published work: the absence of any real debate about the values of rigour and relevance in research; and the under-use of dominant perspectives in business and management research (such as institutional theory) to frame construction management and organizational issues. Drawing specifically upon the ideas of institutional logics and institutional work, this paper explores the tensions, ironies and contradictions of the rigour-relevance debate; and the challenges and opportunities facing construction management research (CMR) and its institutions in furthering management and organizational research agendas. In doing so, attention is directed to the complex, contested and changing nature of the knowledge base within the business and management field; as well as key differences between that community of practice and CMR
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